Awareness and Behavioral Determinants of Passive Smoking and Vaping Among Youth in Larkana: A Cross-Sectional Study
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Background: Passive smoking and vaping represent growing public health concerns, particularly among adolescents and young adults in developing countries where awareness does not consistently translate into behavioral change. Objective: To assess awareness, behavioral patterns, and psychosocial determinants of passive smoking and vaping among youth in Larkana, Pakistan. Methods: A cross-sectional study was conducted from March to August 2025 among 408 participants aged 12–25 years using a structured questionnaire. Descriptive statistics, Chi-square tests, t-tests, ANOVA, and logistic regression were applied to evaluate associations between demographic factors, awareness, and behavioral outcomes. Results: Awareness of passive smoking (81.9%) and vaping risks (83.6%) was high; however, significant gender differences in exposure were observed (χ²=28.338, p<0.001), along with age-related differences in exposure location (F=5.825, p<0.001). Peer pressure emerged as a significant predictor of vaping beliefs (OR=2.053, p=0.002), while awareness campaigns showed no significant association with improved knowledge (r=-0.024, p=0.631). Interpersonal discussions with parents or teachers significantly improved awareness (t=2.185, p=0.029). Effect sizes were small, and regression models demonstrated limited explanatory power (R²=0.04). Conclusion: Despite high awareness, behavioral outcomes remain suboptimal due to strong social influences. Interventions should focus on peer dynamics, community engagement, and behavior-based strategies rather than awareness alone.
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1. N S, B M, Arvindbhai PS, G R. Awareness on passive smoking among Indian adults. Bioinformation. 2023;19(1):10-13. doi:10.6026/97320630019010.
2. Koksoy S, Kara F. Effects of smoking cessation interventions [preprint]. 2021. doi:10.1101/2021.05.06.21256782.
3. EVALI in adolescents. Pediatrics. 2020;146(1):e20194104. doi:10.1542/peds.2019-4104.
4. Ooi JX, Teh KX, Tam CL, Sadasivan S, Kadirvelu A. Passive smoking: perceptions and practices among urban working adults. Int J Collab Res Intern Med Public Health. 2014;6(6):160-167.
5. Kuntz B, Lampert T. Smoking and passive smoke exposure among adolescents in Germany. Dtsch Arztebl Int. 2016;113(3):23-30. doi:10.3238/arztebl.2016.0023.
6. Stalgaitis CA, Djakaria M, Jordan JW. The vaping teenager: understanding the psychographics and interests of adolescent vape users to inform health communication campaigns. Tob Use Insights. 2020;13:1179173X20945695. doi:10.1177/1179173X20945695.
7. Macacu A, Autier P, Boniol M, Boyle P. Active and passive smoking and risk of breast cancer: a meta-analysis. Breast Cancer Res Treat. 2015;154(2):213-224. doi:10.1007/s10549-015-3628-4.
8. Hagstad S, Bjerg A, Ekerljung L, Backman H, Lindberg A, Ronmark E, et al. Passive smoking exposure is associated with increased risk of COPD in never-smokers. Chest. 2014;145(6):1298-1304. doi:10.1378/chest.13-1349.
9. Sabbagh HJ, Hassan MHA, Innes NPT, Elkodary HM, Little J, Mossey PA. Passive smoking in the etiology of non-syndromic orofacial clefts: a systematic review and meta-analysis. PLoS One. 2015;10(3):e0116963. doi:10.1371/journal.pone.0116963.
10. Cao S, Yang C, Gan Y, Lu Z. The health effects of passive smoking: an overview of systematic reviews based on observational epidemiological evidence. PLoS One. 2015;10(10):e0139907. doi:10.1371/journal.pone.0139907.
11. Adda J, Cornaglia F. The effect of bans and taxes on passive smoking. Am Econ J Appl Econ. 2010;2(1):1-32. doi:10.1257/app.2.1.1.
12. US Department of Health and Human Services. Preventing tobacco use among youth and young adults: a report of the Surgeon General. Rockville (MD): US Department of Health and Human Services; 2012.
13. Gentzke AS, Creamer M, Cullen KA, Ambrose BK, Willis G, Jamal A, et al. Vital signs: tobacco product use among middle and high school students—United States, 2011-2018. MMWR Morb Mortal Wkly Rep. 2019;68(6):157-164.
14. King BA, Gammon DG, Marynak KL, Rogers T. Electronic cigarette sales in the United States, 2013-2017. JAMA. 2018;320(13):1379-1380.
15. Asim S, et al. Evaluating the prevalence of vaping (e-cigarettes) and associated factors among private/public college students of Karachi. J Pharm Negat Results. 2023;14:415-422.
16. Iqbal N, Khan ZA, Anwar SMH, et al. Prevalence and knowledge of electronic cigarettes amongst medical students: a cross-sectional survey from Karachi, Pakistan. Eur Respir J. 2017.
17. Sarfraz M, Khan HAR, Urooba A, et al. Awareness, use and perceptions about e-cigarettes among adult smokers in Karachi, Pakistan. J Pak Med Assoc. 2018;68(1):147.
18. Hebert ET, Case KR, Kelder SH, Delk J, Perry CL, Harrell MB. Exposure and engagement with tobacco- and e-cigarette-related social media. J Adolesc Health. 2017;61(3):371-377.
19. Czaplicki L, Kostygina G, Kim Y, et al. Characterising JUUL-related posts on Instagram. Tob Control. 2019.
20. Cullen KA, Gentzke AS, Sawdey MD, et al. E-cigarette use among youth in the United States, 2019. JAMA. 2019;322(21):2095-2103. doi:10.1001/jama.2019.18387.
21. National Academies of Sciences, Engineering, and Medicine. Public health consequences of e-cigarettes. Washington (DC): The National Academies Press; 2018.
22. McConnell R, et al. Electronic cigarette use and respiratory symptoms in adolescents. Am J Respir Crit Care Med. 2017;195:1043-1049.
23. Schweitzer RJ, et al. E-cigarette use and asthma in a multiethnic sample of adolescents. Prev Med. 2017;105:226-231.
24. England LJ, et al. Nicotine and the developing human: a neglected element in the electronic cigarette debate. Am J Prev Med. 2015;49:286-293.
25. Goriounova NA, Mansvelder HD. Short- and long-term consequences of nicotine exposure during adolescence for prefrontal cortex neuronal network function. Cold Spring Harb Perspect Med. 2012;2(12):a012120.
26. Smith RF, et al. Adolescent nicotine induces persisting changes in development of neural connectivity. Neurosci Biobehav Rev. 2015;55:432-443.
27. Barrington-Trimis JL, et al. Psychosocial factors associated with adolescent electronic cigarette and cigarette use. Tob Control. 2015.
28. Saqib MAN, Rafique I, Qureshi H, et al. Burden of tobacco in Pakistan: findings from the Global Adult Tobacco Survey 2014. Nicotine Tob Res. 2018;20(9):1138-1143. doi:10.1093/ntr/ntx266.
29. Flor LS, Anderson JA, Ahmad N, et al. Health effects associated with exposure to secondhand smoke: a Burden of Proof study. Nat Med. 2024;30(1):149-167.
30. Hackshaw AK. Lung cancer and passive smoking. Stat Methods Med Res. 1998;7(2):119-136. doi:10.1177/096228029800700203.
31. Betts KS. Secondhand suspicions: breast cancer and passive smoking. Environ Health Perspect. 2007;115(3):A136-A143. doi:10.1289/ehp.115-a136.
32. Khoso MH, Shah AQ, Shah N, Junejo MR, Brohi M, Noor D, et al. Exploring narcissistic personality traits among medical students: a cross-sectional study using the NPI-16 scale. J Health Wellness Community Res. 2025:e297.
33. Khoso SM, Khoso PA, Qazi N, Khoso MH, Jatoi AS, Kaka U. Histological features of parotid gland of albino rats exposed to smokeless tobacco. J Northeast Agric Univ (Engl Ed). 2016;23(3):54-60.